Scientists suggest government should add psych meds to public drinking water

With a study currently underway in Scotland to assess whether lithium in drinking water is linked with lower suicide rates, we may soon see a renewed push to add yet another bioactive substance to public water supplies.

In 2009, researchers from Oita University in Japan released the results of a study finding that regions of the country with higher naturally occurring levels of lithium in the water had lower levels of suicide than regions with less lithium. This led to a flurry of calls for lithium to be added to public water, much as fluoride is by many municipalities.

Lithium is a naturally occurring chemical element that, at high doses, is used for the treatment of bipolar disorder and severe depression. Side effects of lithium use at these doses include hypothyroidism, weight gain and kidney failure.

Jury still out on lithium’s health effects

In 1990, a study found that, among 27 Texas counties, those with the highest levels of lithium in the water had suicide rates as much as 40 percent lower than counties with the lowest levels. Higher rates of lithium were also associated with lower levels of homicide and rape. In 2009, this research was replicated by the Oita team, which compared 18 Japanese municipalities and found similar suicide findings. The Japanese study has been replicated several times since then, with mostly similar findings but a few studies finding no correlation.

Now, a Scottish research team is conducting their own version of the Japanese study, attempting to correct for some of the methodological flaws of earlier research.

“We want to improve the methodology by looking at smaller postcode areas,” lead research Daniel Smith said.

Results are expected in 2016.

Violation of informed consent

Even if the Scottish team’s findings contradict prior studies, the idea of adding lithium to the water may already have taken on a life of its own. In a recent editorial for The New York Times, Weill Cornel Medical College psychiatrist downplayed the risks of lithium supplementation, calling the debate “moot.”

“Mother Nature has already put a psychotropic drug in the drinking water, and that drug is lithium,” she wrote.

In 2010, bioethicist and medical historian Jacob M. Appel prominently called for adding lithium to water in a Huffington Post editorial, if further research showed acceptably low risk.

“If low-dose lithium proves as good as its promise, we should not allow abstract arguments about our ‘freedom’ to drink unadulterated water to prevent us from undertaking a mass fortification effort,” he wrote.

He then went on to suggest that it might also be good to add cholesterol-lowering (and brain-killing) statins to public water, along with “thiamine [to] prevent dementia in alcoholics.”

“Some nay-sayers will inevitably argue that medically fortifying the public water is a violation of individual liberty,” he dismissively wrote. “Of course, nobody is forcing those dissident individuals to drink tap water. They are welcome to purchase bottled water.”

But questions of effectiveness, risk and liberty aside, many critics have argued that no water fortification effort could ever be ethical. According to Robert Carton, a former EPA senior scientist, adding any drug to drinking water violates a patient’s right to give informed consent before undergoing any medical intervention. And in this case, everyone who drinks water becomes a patient.

Carton and others have applied the same critique to water fluoridation.

“All ethical codes for the protection of individuals who are subject to medical procedures, whether research or routine medical treatment, endorse the basic requirement for voluntary informed consent,” Carton wrote in the International Journal of Occupational and Environmental Health.

Other critics have noted that adding drugs to public water also violates medical ethics by making it impossible to customize doses to individuals’ medical needs and risk profiles.